Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2012
ReviewSurgical treatment of osteochondritis dissecans of the talus: a systematic review.
Osteochondritis dissecans (OCD) is an aseptic bone necrosis and represents pathology of high clinical relevance, which is frequently located on the talus. Various treatment strategies including non-surgical and surgical approaches have been described. An evidence-based treatment algorithm is still lacking. The present systematic review focuses on surgical treatment options and their stage-dependent outcome described for treatment of osteochondritis dissecans of the talus with special regard to the best available evidence. ⋯ Although OCD of the talus represents a frequently observed orthopedic pathology, evidence concerning operative treatment of osteochondrosis dissecans of the talus is still elusive. With over 1,100 included patients in the present study, no strong recommendations based upon scientific evidence can be given.
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Arch Orthop Trauma Surg · Sep 2012
ReviewRevision anterior cruciate ligament reconstruction: an update.
With the rising number of anterior cruciate ligament (ACL) reconstructions performed, revision ACL reconstruction is increasingly common nowadays. A broad variety of primary and revision ACL reconstruction techniques have been described in the literature. Recurrent instability after primary ACL surgery is often due to non-anatomical ACL graft reconstruction and altered biomechanics. ⋯ Recently, revision ACL reconstruction has been described using double bundle hamstring graft. Successful revision ACL reconstruction requires an exact understanding of the causes of failure and technical or diagnostic errors. The purpose of this article is to review the causes of failure, preoperative evaluation, graft selection and types of fixation, tunnel placement, various types of surgical techniques and clinical outcome of revision ACL reconstruction.
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Arch Orthop Trauma Surg · Sep 2012
ReviewWhich procedure is better for lumbar interbody fusion: anterior lumbar interbody fusion or transforaminal lumbar interbody fusion?
Both anterior lumbar interbody fusion (ALIF) and transforaminal lumbar interbody fusion (TLIF) surgeries are performed to obtain a solid fusion to treat lumbar spondylosis. This systematic review investigated whether surgical complications, nonfusion rate, radiographic outcome, and clinical outcome of ALIF were significantly different from those of TLIF. ⋯ Clinical outcomes and nonfusion rate in ALIF were similar to TLIF. However, the restoration of disc height, segmental lordosis, and whole lumbar lordosis in ALIF were superior to those in TLIF, while blood loss, operative time, and costs in ALIF were greater than in TLIF.
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Arch Orthop Trauma Surg · Sep 2012
Comparative StudySTT arthrodesis versus proximal row carpectomy for Lichtman stage IIIB Kienböck's disease: first results of an ongoing observational study.
Scapho-trapezial-trapezoidal (STT) arthrodesis and proximal row carpectomy (PRC) are used for the treatment of Lichtman stage IIIB Kienböck's disease. This study prospectively compares 1-year results of STT arthrodesis and PRC in Lichtman stage IIIB Kienböck's disease. ⋯ One year after operation, slightly better results were observed in patients with PRC compared to STT arthrodesis.
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Arch Orthop Trauma Surg · Sep 2012
Case ReportsCustom rotating-hinge total knee replacement in patients with spina bifida and severe neuromuscular dysfunction.
Spina bifida (SB) is a congenital disorder which may result in a number of musculoskeletal problems. Total knee replacement (TKR) in this patient group is technically demanding due to bone deformity, soft tissue contracture, muscle tone abnormality and ligament insufficiency. This is a retrospective review of three patients with SB and disabling knee arthritis who were managed with a custom rotating-hinge (RHK) total knee system. ⋯ Mean Oxford Knee score improved from 21 preoperatively to 32 at final follow-up. One patient required revision of tibial and patella components at 37 months for lateral patella instability and excessive wear. Custom RHK for patients with SB, severe neuromuscular dysfunction and bone deformity relieves pain, restores stability and improves early knee function; however there is a significant risk of extensor mechanism complications and functional outcome is worse than primary TKR in the general population.